This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. A. SPECIFIC AIMS This hypothesis will be tested through the following specific aims: 1. Assess the effect of standard-versus-aggressive RAAS inhibition on progression of atherosclerotic disease on a primary outcome of structural vascular changes as assessed by carotid intima media thickness, 2. Assess the effect of standard-versus-aggressive RAAS inhibition on progression of atherosclerotic disease on a secondary outcome of functional vascular changes as assessed by finger plethysmography, and 3. Examine the relationship of vascular changes to both baseline and change in urinary protein excretion rates.